The prognostic value of the ECG in hypertension

where are we now?

D. S. C. Ang, C. C. Lang

    Research output: Contribution to journalReview article

    30 Citations (Scopus)

    Abstract

    In hypertension, the presence of left ventricular hypertrophy (LVH) is associated with increased risk of both cardiovascular morbidity and mortality. To date, the electrocardiogram (ECG) remains the cornerstone of LVH diagnosis in clinical practice because it is universally available, technically easy to perform and highly specific. In the most recent European Society of Hypertension/European Society of Cardiology guidelines for the treatment of arterial hypertension, the Sokolow-Lyon voltage criterion was recommended as part of all routine assessment of subjects with hypertension. However, the use of the ECG in the diagnosis of LVH is somewhat limited by its poor sensitivity. In this review article, we discuss the individual strength and weaknesses of the commonly used ECG criteria in diagnosing LVH. In addition, we present the latest data on the prognostic significance of ECG LVH and the survival differences conferred in different genders. In view of the recent Losartan Intervention for Endpoint Reduction in Hypertension trial, the prognostic benefit of LVH regression will also be addressed. Finally, with the wider availability of echocardiography, the role of combining both modalities to improve risk stratification in hypertension is reviewed.

    Original languageEnglish
    Pages (from-to)460-467
    Number of pages8
    JournalJournal of Human Hypertension
    Volume22
    Issue number7
    DOIs
    Publication statusPublished - Jul 2008

    Keywords

    • electrocardiography
    • echocardiography
    • left ventricular hypertrophy
    • prevalence
    • prognosis and regression
    • LEFT-VENTRICULAR HYPERTROPHY
    • ELECTROCARDIOGRAPHIC STRAIN PATTERN
    • CORONARY-ARTERY DISEASE
    • END-POINT REDUCTION
    • LOSARTAN INTERVENTION
    • CARDIOVASCULAR RISK
    • PREDICT MORTALITY
    • SERIAL CHANGES
    • CRITERIA
    • PREVALENCE

    Cite this

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    title = "The prognostic value of the ECG in hypertension: where are we now?",
    abstract = "In hypertension, the presence of left ventricular hypertrophy (LVH) is associated with increased risk of both cardiovascular morbidity and mortality. To date, the electrocardiogram (ECG) remains the cornerstone of LVH diagnosis in clinical practice because it is universally available, technically easy to perform and highly specific. In the most recent European Society of Hypertension/European Society of Cardiology guidelines for the treatment of arterial hypertension, the Sokolow-Lyon voltage criterion was recommended as part of all routine assessment of subjects with hypertension. However, the use of the ECG in the diagnosis of LVH is somewhat limited by its poor sensitivity. In this review article, we discuss the individual strength and weaknesses of the commonly used ECG criteria in diagnosing LVH. In addition, we present the latest data on the prognostic significance of ECG LVH and the survival differences conferred in different genders. In view of the recent Losartan Intervention for Endpoint Reduction in Hypertension trial, the prognostic benefit of LVH regression will also be addressed. Finally, with the wider availability of echocardiography, the role of combining both modalities to improve risk stratification in hypertension is reviewed.",
    keywords = "electrocardiography, echocardiography, left ventricular hypertrophy, prevalence, prognosis and regression, LEFT-VENTRICULAR HYPERTROPHY, ELECTROCARDIOGRAPHIC STRAIN PATTERN, CORONARY-ARTERY DISEASE, END-POINT REDUCTION, LOSARTAN INTERVENTION, CARDIOVASCULAR RISK, PREDICT MORTALITY, SERIAL CHANGES, CRITERIA, PREVALENCE",
    author = "Ang, {D. S. C.} and Lang, {C. C.}",
    year = "2008",
    month = "7",
    doi = "10.1038/jhh.2008.24",
    language = "English",
    volume = "22",
    pages = "460--467",
    journal = "Journal of Human Hypertension",
    issn = "0950-9240",
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    }

    The prognostic value of the ECG in hypertension : where are we now? / Ang, D. S. C.; Lang, C. C.

    In: Journal of Human Hypertension, Vol. 22, No. 7, 07.2008, p. 460-467.

    Research output: Contribution to journalReview article

    TY - JOUR

    T1 - The prognostic value of the ECG in hypertension

    T2 - where are we now?

    AU - Ang, D. S. C.

    AU - Lang, C. C.

    PY - 2008/7

    Y1 - 2008/7

    N2 - In hypertension, the presence of left ventricular hypertrophy (LVH) is associated with increased risk of both cardiovascular morbidity and mortality. To date, the electrocardiogram (ECG) remains the cornerstone of LVH diagnosis in clinical practice because it is universally available, technically easy to perform and highly specific. In the most recent European Society of Hypertension/European Society of Cardiology guidelines for the treatment of arterial hypertension, the Sokolow-Lyon voltage criterion was recommended as part of all routine assessment of subjects with hypertension. However, the use of the ECG in the diagnosis of LVH is somewhat limited by its poor sensitivity. In this review article, we discuss the individual strength and weaknesses of the commonly used ECG criteria in diagnosing LVH. In addition, we present the latest data on the prognostic significance of ECG LVH and the survival differences conferred in different genders. In view of the recent Losartan Intervention for Endpoint Reduction in Hypertension trial, the prognostic benefit of LVH regression will also be addressed. Finally, with the wider availability of echocardiography, the role of combining both modalities to improve risk stratification in hypertension is reviewed.

    AB - In hypertension, the presence of left ventricular hypertrophy (LVH) is associated with increased risk of both cardiovascular morbidity and mortality. To date, the electrocardiogram (ECG) remains the cornerstone of LVH diagnosis in clinical practice because it is universally available, technically easy to perform and highly specific. In the most recent European Society of Hypertension/European Society of Cardiology guidelines for the treatment of arterial hypertension, the Sokolow-Lyon voltage criterion was recommended as part of all routine assessment of subjects with hypertension. However, the use of the ECG in the diagnosis of LVH is somewhat limited by its poor sensitivity. In this review article, we discuss the individual strength and weaknesses of the commonly used ECG criteria in diagnosing LVH. In addition, we present the latest data on the prognostic significance of ECG LVH and the survival differences conferred in different genders. In view of the recent Losartan Intervention for Endpoint Reduction in Hypertension trial, the prognostic benefit of LVH regression will also be addressed. Finally, with the wider availability of echocardiography, the role of combining both modalities to improve risk stratification in hypertension is reviewed.

    KW - electrocardiography

    KW - echocardiography

    KW - left ventricular hypertrophy

    KW - prevalence

    KW - prognosis and regression

    KW - LEFT-VENTRICULAR HYPERTROPHY

    KW - ELECTROCARDIOGRAPHIC STRAIN PATTERN

    KW - CORONARY-ARTERY DISEASE

    KW - END-POINT REDUCTION

    KW - LOSARTAN INTERVENTION

    KW - CARDIOVASCULAR RISK

    KW - PREDICT MORTALITY

    KW - SERIAL CHANGES

    KW - CRITERIA

    KW - PREVALENCE

    U2 - 10.1038/jhh.2008.24

    DO - 10.1038/jhh.2008.24

    M3 - Review article

    VL - 22

    SP - 460

    EP - 467

    JO - Journal of Human Hypertension

    JF - Journal of Human Hypertension

    SN - 0950-9240

    IS - 7

    ER -